Attention-Deficit/Hyperactivity Disorder (ADHD): Integrating the MOXO-dCPT with an Eye Tracker Enhances Diagnostic Precision.

Clinical decision-making may be enhanced when combining psychophysiological sensors with computerized neuropsychological tests. The current study explored the utility of integrating an eye tracker with a commercially available continuous performance test (CPT), the MOXO-dCPT. As part of the study, the performance of adult attention-deficit/hyperactivity disorder (ADHD) patients and healthy controls (n = 43, n = 42, respectively) was compared in the integrated system. More specifically, the MOXO-dCPT has four stages, which differ in their combinations of ecological visual and auditory dynamic distractors. By exploring the participants' performance in each of the stages, we were able to show that: (a) ADHD patients spend significantly more time gazing at irrelevant areas of interest (AOIs) compared to healthy controls; (b) visual distractors are particularly effective in impacting ADHD patients' eye movements, suggesting their enhanced utility in diagnostic procedures; (c) combining gaze direction data and conventional CPT indices enhances group prediction, compared to the sole use of conventional indices. Overall, the findings indicate the utility of eye tracker-integrated CPTs and their enhanced diagnostic precision. They also suggest that the use of attention-grabbing visual distractors may be a promising path for the evolution of existing CPTs by shortening their duration and enhancing diagnostic precision.

Mapping Grip Force Characteristics in the Measurement of Stress in Driving.

Reducing drivers' stress can potentially increase road safety. However, state-of-the-art physiological stress indices are intrusive and limited by long time lags. Grip force is an innovative index of stress that is transparent to the user and, according to our previous findings, requires a two- to five-second time window. The aim of this study was to map the various parameters affecting the relationship between grip force and stress during driving tasks. Two stressors were used: the driving mode and the distance from the vehicle to a crossing pedestrian. Thirty-nine participants performed a driving task during either remote driving or simulated driving. A pedestrian dummy crossed the road without warning at two distances. The grip force on the steering wheel and the skin conductance response were both measured. Various model parameters were explored, including time window parameters, calculation types, and steering wheel surfaces for the grip force measurements. The significant and most powerful models were identified. These findings may aid in the development of car safety systems that incorporate continuous measurements of stress.

Feigned ADHD Associated Cognitive Impairment: Utility of Integrating an Eye-tracker and the MOXO-dCPT.

OBJECTIVE: The current study assessed the utility of eye-movements measures, gathered while participants performed a commercially available Continuous Performance Test (CPT), to detect feigned ADHD-associated cognitive impairment. METHOD: Healthy simulators (n = 37), ADHD patients (n = 33), and healthy controls (n = 36) performed an eye-tracker integrated MOXO-dCPT and a stand-alone validity indicator. RESULTS: Simulators gazed significantly longer at regions that were irrelevant for successful MOXO-dCPT performance compared to ADHD patients and healthy controls. This eye-movement measure, however, had lower sensitivity than traditional MOXO-dCPT indices. DISCUSSION: Gaze direction measures, gathered while performing a CPT, show initial promise as validity indicators. Traditional CPT measures, however, are more sensitive and therefore offer a more promising path for the establishment of CPT-based validity indicators. The current study is an initial exploration of the issue and further evaluation of both theoretical and practical aspects is mandated.

Identifying Feigned Cognitive Impairment: Investigating the Utility of Diffusion Model Analyses.

Forced-choice performance validity tests are routinely used for the detection of feigned cognitive impairment. The drift diffusion model deconstructs performance into distinct cognitive processes using accuracy and response time measures. It thereby offers a unique approach for gaining insight into examinees' speed-accuracy trade-offs and the cognitive processes that underlie their performance. The current study is the first to perform such analyses using a well-established forced-choice performance validity test. To achieve this aim, archival data of healthy participants, either simulating cognitive impairment in the Word Memory Test or performing it to the best of their ability, were analyzed using the EZ-diffusion model (N = 198). The groups differed in the three model parameters, with drift rate emerging as the best predictor of group membership. These findings provide initial evidence for the usefulness of the drift diffusion model in clarifying the cognitive processes underlying feigned cognitive impairment and encourage further research.

Eye Tracking During a Continuous Performance Test: Utility for Assessing ADHD Patients.

OBJECTIVE: The use of continuous performance tests (CPTs) for assessing ADHD related cognitive impairment is ubiquitous. Novel psychophysiological measures may enhance the data that is derived from CPTs and thereby improve clinical decision-making regarding diagnosis and treatment. As part of the current study, we integrated an eye tracker with the MOXO-dCPT and assessed the utility of eye movement measures to differentiate ADHD patients and healthy controls. METHOD: Adult ADHD patients and gender/age-matched healthy controls performed the MOXO-dCPT while their eye movements were monitored (n = 33 per group). RESULTS: ADHD patients spent significantly more time gazing at irrelevant regions, both on the screen and outside of it, than healthy controls. The eye movement measures showed adequate ability to classify ADHD patients. Moreover, a scale that combined eye movement measures enhanced group prediction, compared to the sole use of conventional MOXO-dCPT indices. CONCLUSIONS: Integrating an eye tracker with CPTs is a feasible way of enhancing diagnostic precision and shows initial promise for clarifying the cognitive profile of ADHD patients. Pending replication, these findings point toward a promising path for the evolution of existing CPTs.

Sex-specific cognitive effects of mild traumatic brain injury to the frontal and temporal lobes.

BACKGROUND: Cognitive deficits are the most enduring and debilitating sequelae of mild traumatic brain injury (mTBI). However, relatively little is known about whether the cognitive effects of mTBI vary with respect to time post-injury, biological sex, and injury location. OBJECTIVES: The aim of this study was to assess the effect of the side and site of mTBI and to determine whether these effects are sexually dimorphic. METHODS: Male and female ICR mice were subjected to either a sham procedure or mTBI to the temporal lobes (right-sided or left-sided) or to the frontal lobes (bilateral) using a weight-drop model. After recovery, mice underwent a battery of behavioral tests at two post-injury time points. RESULTS: Different mTBI impact locations produced dissociable patterns of memory deficits; the extent of these deficits varied across sexes, time points, and memory domains. In both sexes, frontal mTBI mice exhibited a delayed onset of spatial memory deficits. Additionally, the performance of the frontal and left temporal injured males and females was more variable than that of controls. Interestingly, only in females does the effect of mTBI on visual recognition memory depend on the time post-injury. Moreover, only in females does spatial recognition memory remain relatively intact after mTBI to the left temporal lobe. CONCLUSION: This study showed that different mTBI impact sites produce dissociable and sex-specific patterns of cognitive deficits in mice. The results emphasize the importance of considering the injury site/side and biological sex when evaluating the cognitive sequelae of mTBI.

Grip Force on Steering Wheel as a Measure of Stress.

Driver performance is crucial for road safety. There is a relationship between performance and stress such that too high or too low stress levels (usually characterized by stressful or careless driving, respectively) impair driving quality. Therefore, monitoring stress levels can improve the overall performance of drivers by providing either an alert or intervention when stress levels are sub-optimal. Commonly used stress measures suffer from several shortcomings, such as time delays in indication and invasiveness of sensors. Grip force is a relatively new measure that shows promising results in measuring stress during psychomotor tasks. In driving, grip force sensor is non-invasive and transparent to the end user as drivers must continuously grip the steering wheel. The aim of the current research is to examine whether grip force can be used as a useful measure of stress in driving tasks. Twenty-one participants took part in a field experiment in which they were required to brake the vehicle in various intensities. The effects of the braking intensity on grip force, heart rate, and heart rate variability were analyzed. The results indicate a significant correlation between these three parameters. These results provide initial evidence that grip force can be used to measure stress in driving tasks. These findings may have several applications in the field of stress and driving research as well as in the vehicle safety domain.

Detection of Feigned ADHD Using the MOXO-d-CPT.

Objective: The objective of this study was to assess the MOXO-d-CPT utility in detecting feigned ADHD and establish cutoffs with adequate specificity and sensitivity. Method: The study had two phases. First, using a prospective design, healthy adults who simulated ADHD were compared with healthy controls and ADHD patients who performed the tasks to the best of their ability (n = 47 per group). Participants performed the MOXO-d-CPT and an established performance validity test (PVT). Second, the MOXO-d-CPT classification accuracy, employed in Phase 1, was retrospectively compared with archival data of 47 ADHD patients and age-matched healthy controls. Results: Simulators performed significantly worse on all MOXO-d-CPT indices than healthy controls and ADHD patients. Three MOXO-d-CPT indices (attention, hyperactivity, impulsivity) and a scale combining these indices showed adequate discriminative capacity. Conclusion: The MOXO-d-CPT showed promise for the detection of feigned ADHD and, pending replication, can be employed for this aim in clinical practice and ADHD research.

Establishing supplementary response time validity indicators in the Word Memory Test (WMT) and directions for future research.

Response time (RT) measures in the Word Memory Test (WMT) offer to complement information derived from conventional accuracy measures. The current study aimed to validate the findings of Lupu, Elbaum, Wagner, and Braw in which RT variability was assessed, for the first time, in the WMT. A secondary aim was to suggest directions for the future research of RT measures in Forced-Choice Recognition Memory Performance Validity Tests (FCRM-PVTs). The study utilized a simulation research design, with participants performing the WMT's immediate recognition (IR) subtest (N = 59). Mean RTs and a scale which combines accuracy and RT measures, but not variability in RTs, possessed adequate discrimination capacity. Enhanced discrimination capacity was found after discarding the first items' RTs, though the IR-subtest's accuracy measure still showed superiority as a stand-alone validity indicator. The promise of RT measures may, therefore, lie in their ability to illuminate speed-accuracy tradeoffs among examinees with border-zone accuracy scores in FCRM-PVTs. They should, therefore, be regarded as complementary to conventional accuracy measures.

Cyclopean, Dominant, and Non-dominant Gaze Tracking for Smooth Pursuit Gaze Interaction.

User-centered design questions in gaze interfaces have been explored in multitude empirical investigations. Interestingly, the question of what eye should be the input device has never been studied. We compared tracking accuracy between the "cyclopean" (i.e., midpoint between eyes) dominant and non-dominant eye. In two experiments, participants performed tracking tasks. In Experiment 1, participants did not use a crosshair. Results showed that mean distance from target was smaller with cyclopean than with dominant or non-dominant eyes. In Experiment 2, participants controlled a crosshair with their cyclopean, dominant and non-dominant eye intermittently and had to align the crosshair with the target. Overall tracking accuracy was highest with cyclopean eye, yet similar between cyclopean and dominant eye in the second half of the experiment. From a theoretical viewpoint, our findings correspond with the cyclopean eye theory of egocentric direction and provide indication for eye dominance, in accordance with the hemispheric laterality approach. From a practical viewpoint, we show that what eye to use as input should be a design consideration in gaze interfaces.